Dr. M.J. Bazos, Patient
WHAT IS BACK
Most back pain is caused by
muscle strain, trauma or spinal deformity. Only about 10 percent of back pain is
caused by a systemic illness. Back pain can develop anywhere from the neck to
the lower spine.The pain can be localized or spread across a wide area and
radiate from a central
pain has many causes, including overuse, trauma, degeneration of vertebrae,
infection, or tumor. The exact cause of pain may be difficult to identify, since
it can come from soft tissue, bone, disc ornerves. Risk factors for low back
pain include cigarette smoking, jobs that require repetitive or heavy lifting,
and exposure to vibration produced by vehicles or industrial machinery. Certain
sports, such as cross-country skiing, and prolonged vehicle driving are also
associated with back pain. Diseases such as spinal osteoarthritis, spondylitis
and compression fractures can also cause pain. Some of these diseases are more
prevalent in the elderly, consequently older people are at higher risk for back
- Back pain is the most prevalent medical disorder
in industrialized societies.
- Low back pain disables 5.4 million Americans and
costs at least $16 billion each year.
- Two-thirds of all adults will experience at least
one episode of back pain in their lifetime.
- Seventy percent of people with back pain recover
within a month.
- Symptoms persist for more than six months in only
4 percent of the cases, but this group accounts for 85 percent of the money
spent on treatment and compensation for low back pain.
- About half of the people with chronic back pain
return to work.
should determine whether pain is musculoskeletal, neurological or from one of
the organs. This diagnosis is based on a careful history and physical
examination. Injection of a local anesthetic and/or steroid into soft tissue or
joint spaces can be helpful in diagnosing and treating back pain. Imaging
procedures that assist in identifying the pain source include the x-ray, bone
scan, computerized tomography (CAT scan) and magnetic resonance imaging (MRI).
Expensive imaging procedures are generally reserved for patients whose diagnosis
is not apparent with more conventional diagnostic
pain relievers, such as aspirin, acetaminophen and non-steroidal
anti-inflammatory drugs, are often the only treatment necessary for back pain.
Patients should avoid any activity that increases the pain. For persistent pain,
assistance from a rheumatologist should be obtained. Treatment should be
directed at the specific cause of pain. Management techniques include
analgesics, anti-inflammatories, antidepressants, muscle relaxants and
rehabilitation exercises. Mechanical back supports are usually recommended for
limited periods of time in certain situations, such as post-operative patients.
If these techniques fail within a reasonable time, injections with local
anesthetics and steroids can be helpful. Surgery can be very helpful when
comprehensive nonoperative therapy fails. Physical and occupational therapy are
important forms of treatment.
DOCTOR’S ROLE IN TREATING BACK
Docrors are competent to
completely evaluate patients with back pain and to plan a treatment program.
Since surgery is indicated for only a small percentage of patients, it is likely
that your doctor can significantly reduce the cost of back pain by reducing
hospitalization, expensive imaging procedures, excessive physical therapy visits